Lechien Jérôme R
Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology - Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France; Department of Otolaryngology, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France; Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Brussels, Belgium.
J Voice. 2025 Jul 21. doi: 10.1016/j.jvoice.2025.07.003.
To investigate the detection and patterns of pharyngeal reflux events in laryngopharyngeal reflux disease (LPRD) patients according to the type of ambulatory hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) system used and assessed whether potential HEMII-pH differences impact the pretreatment to post treatment findings.
Patients with laryngopharyngeal symptoms and findings and an objective LPRD diagnosis were prospectively recruited from the European Reflux Clinic from January 2017 to December 2024. The objective diagnosis was supported by two different HEMII-pH systems (Medtronic and Sandhill). The profiles of LPRD on the objective testing devices (acid, weakly acid, and alkaline LPRD) of patients from the same clinic were prospectively compared. Reflux symptom scores (RSS) and reflux sign assessment (RSA) were used to document prepersonalized to postpersonalized treatment symptoms and findings. A study of the correlation between HEMII-pH features, symptoms, and signs was conducted.
The study included gender- and age-matched 101 patients with a Sandhill HEMII-pH and 102 patients with a Medtronic HEMII-pH. Both systems detected distal esophageal reflux events similarly, but Medtronic detected significantly more pharyngeal reflux events. The Sandhill group showed higher proportions of acid and weakly acid LPRD, while Medtronic patients predominantly had alkaline reflux. Patients of both groups demonstrated significant RSS reduction after treatment (P = 0.001), with a trend toward higher response rates in the Sandhill group (P = 0.067). Symptom scores were better correlated to the Sandhill pharyngeal reflux event features than the Medtronic one.
The patterns of LPRD can substantially vary according to the type and catheter configuration of ambulatory HEMII-pH systems used. The differences between HEMII-pH devices support the need for revising consensus statements defining the thresholds of pharyngeal reflux events for confirming the LPRD diagnosis.
根据使用的动态下咽-食管多通道腔内阻抗-pH监测（HEMII-pH）系统类型，研究喉咽反流病（LPRD）患者的咽反流事件检测及模式，并评估潜在的HEMII-pH差异是否会影响治疗前后的结果。
2017年1月至2024年12月期间，从欧洲反流诊所前瞻性招募有喉咽症状和体征且客观诊断为LPRD的患者。客观诊断由两种不同的HEMII-pH系统（美敦力和山德希尔）支持。对同一诊所患者在客观检测设备上的LPRD特征（酸性、弱酸性和碱性LPRD）进行前瞻性比较。反流症状评分（RSS）和反流体征评估（RSA）用于记录个性化治疗前和治疗后的症状及体征。对HEMII-pH特征、症状和体征之间的相关性进行研究。
该研究纳入了101例使用山德希尔HEMII-pH系统和102例使用美敦力HEMII-pH系统的性别和年龄匹配的患者。两种系统对远端食管反流事件的检测相似，但美敦力检测到的咽反流事件明显更多。山德希尔组酸性和弱酸性LPRD的比例较高，而美敦力患者主要为碱性反流。两组患者治疗后RSS均显著降低（P = 0.001），山德希尔组的缓解率有更高的趋势（P = 0.067）。症状评分与山德希尔咽反流事件特征的相关性优于美敦力。
LPRD的模式可能会因使用的动态HEMII-pH系统类型和导管配置而有很大差异。HEMII-pH设备之间的差异支持有必要修订定义咽反流事件阈值以确认LPRD诊断的共识声明。
